Recommendations set forth by the Health Department and NYPD will provide new ways for City agencies to reach the narrow population of New Yorkers with untreated mental illness who may pose a danger to themselves or others
The de Blasio administration announced today that it will strengthen and expand its approach to supporting the narrow population of New Yorkers with untreated serious mental illness who pose a risk for violent behavior. City agencies will work together to refer more New Yorkers to treatment and keep them engaged in the right level of care—ensuring that no person in need falls through the cracks. This commitment stems from a 30-day review led by the Health Department and the NYPD.
“We have an obligation to address our broken mental health system and do all we can to connect people who are struggling to treatment,” said Mayor Bill de Blasio. “That includes the small percentage of those with mental illness that, left untreated, are at risk of committing violence against themselves or others. These reforms will keep our neighborhoods and city streets safe, ensuring that no New Yorker in need falls through the cracks.”
To address the broken state of our mental health system at the state and federal level, the de Blasio Administration has pledged historic investments in programs and services. Hundreds of thousands of New Yorkers who have mental health needs are successfully treated in the community each year. Over the last few years the City has created new programs to connect even more New Yorkers in need to treatment. Additionally, to reach the narrow population of New Yorkers with untreated serious mental illness who also pose a concern for violent behavior, the City created NYC Safe in 2015. NYC Safe a network of intensive mental health intervention programs for people with untreated serious mental illness who pose a risk of violence and whose care requires close coordination between City services. The program is overseen by a team at the Department of Health and Mental Hygiene that triages cases and connects high-risk individuals with treatment and follow up.
In 2016, the City launched new mobile mental health treatment teams, which provide intensive, ongoing clinical care to people in their communities, in addition to Co-Response Teams, which are comprised of a mental health professional and police officers who proactively engage clients with serious mental health needs and demonstrated violence, connecting them to care and other stabilizing supports such as housing or family.
Through a new, $21 million investment, the City will fund $9.4 million for the Health Department to expand its mobile treatment teams with the goal of connecting more New Yorkers to intensive mental health services and resources. In addition to offering intensive mental health services through the mobile treatment teams, the increased funding will permit the hiring of additional social workers, housing specialists, and legal assistance services to ensure those who are currently undergoing intensive mental health treatment receive comprehensive support.
The Administration will also invest $11 million in Health + Hospitals to create hospital-based outreach teams to coordinate care for people who frequent emergency rooms and other acute care settings. Through this effort, it is estimated that emergency room visits made by this population would decrease by 10%.
As a result of the Review, the City will make the following reforms to reach the narrow population of New Yorkers with untreated mental illness who may pose a danger to themselves or others:
Improve communication between agencies and the process of referring New Yorkers to treatment:
- Train more city agency staff that come into contact with people who have serious mental illness – such as the Department of Homeless Services and Health + Hospitals – to refer these individuals for intensive mobile treatment.
- Deploy NYPD resources to increase referrals to the Triage Desk, which sends both Co-Response Teams and Health Engagement and Assessment Teams (HEAT) to assist those in need of mental health interventions.
- The city will share data related to high-risk individuals to enhance PSYCKES, a web based application developed by the NYS Office of Mental Health (OMH) and widely used by hospitals and outpatient providers. The city and OMH will also collaborate on the development of new PSYCKES features for providers to support identification and care coordination for vulnerable high risk individuals.
Connect more New Yorkers to the right level of treatment:
- Create an interagency coordination team between the Department of Homeless Services and Health + Hospitals to ensure smooth transfer between agencies for people who are experiencing homelessness. The coordination begins prior to hospitalization and continues throughout the hospital stay.
- Immediately hire additional staff at the Health Department to process the 20% expected increase in mental health referrals as a result of the strategies announced today and make assignments to appropriate level of care. This will result in approximately 900 additional people each year receiving the treatment they need.
- Make it easier for intensive treatment teams to visit clients in correctional facilities.
Actively engage New Yorkers who drop out of treatment to keep them in care:
· Provide NYPD Officers with notice of individuals with AOT orders who have dropped out of court mandated treatment so that when an officer encounters them, they will be brought to a hospital. Additionally, NYPD will develop a protocol to transport people with AOT warrants to hospitals, as required by law, so they can be assessed and reconnected to treatment.
· Convene care conferences to ensure individuals in homeless shelters stay connected to treatment.
· The Health Department will review information with the Department of Homeless Services, NYPD, Health + Hospitals, and the Department of Correction to determine whether anyone who has been missing from treatment has had contact with any of those agencies to help reconnect them to care.
· Revise the Riker’s release process to increase successful connections to a treatment team at time of release.
· Increase Kendra’s Law applications to courts for review, and explore critical, legislative changes to state law to maximize the use of Assisted Outpatient Treatment (AOT):
· Nearly 2,500 individuals were mandated to Assisted Outpatient Treatment (AOT under Kendra’s Law) last year, a 27% increase since the beginning of this administration. The proposed changes would build on this approach, and ensure that the narrow population of individuals who may pose a threat to themselves or others remain connected to treatment.
The agencies involved in the initial review – DOHMH, NYPD, H+H, DHS, FDNY, NYPD and the Mayor’s Office of ThriveNYC– will continue exploring ways to improve how people with serious mental illness are connected to care.
“Our commitment to mental health for all demands that we reach New Yorkers living with the most serious mental illness to ensure they are meaningfully connected to care and treatment,” said Deputy Mayor for Health and Human Services Dr. Raul Perea-Henze. “This approach takes deeper collaboration across City government and strategic investments to ensure access to care for all those who need it.”
“People with serious mental illness are our neighbors, friends, and family and they deserve support instead of stigma,” said Health Commissioner Dr. Oxiris Barbot. “We want New Yorkers in need to be able to easily connect to the right level of treatment in their communities where they can remain connected to their families and other support networks.”
“NYPD officers ensure the safety of every New Yorker in every neighborhood across the five boroughs,” said Chief of Department Terence Monahan. “They are well trained and equipped to connect people with mental illness to the proper services they deserve. Working alongside our partner agencies we remain committed to our mission of helping every person we proudly serve.”
“Our City is committed to connecting our neighbors experiencing significant challenges with the help and support they need to find stability,” said Social Services Commissioner Steven Banks. “Through close partnerships, innovative approaches, and new proactive interventions, we will continually enhance our efforts to support New Yorkers in need, from addressing housing crises to resolving mental health challenges through a holistic range of services. As we all work together to close gaps in programs and strengthen our safety net for all, we are determined to keep doing better by those we serve, as well as those who may need our services, but may not be ready to accept assistance yet.”
“As we strengthen our support and safety net system for people with serious mental illness, a coordinated approach to behavioral health care is critical,” said Mitchell Katz, MD, President and CEO of NYC Health + Hospitals. “Constant communication between all agencies who serve this population, will ensure that they receive the necessary care and services they need and deserve.”
EDITOR'S NOTE:
We intentionally left out the comments of the few elected officials the mayor could get to praise these recommendations, and they are recommendations not new policy which the new mayor who was very vocal at the time he was Public Advocate should have done in at least his second or third year, not in his sixth year as mayor.
A mayor who was a city councilman for eight years, and then Public Advocate for only four years should know what New York City needs in his run for mayor of the city. Does it take this mayor ten years to find out the real problems of the city he has now run for six years as mayor, and four years as Public Advocate?
